Key result
Anodal capture can mask left ventricular lead dislodgement by maintaining an unchanged pacing threshold, delaying diagnosis until radiographic confirmation and lead relocation.
Case Report (n=1)
Anodal capture can mask LV lead dislodgement by maintaining pacing thresholds, highlighting the importance of imaging and ECG in suspected cases.
Clinicians should consider anodal capture when LV thresholds remain stable post-CRT; case report leaves open prevalence and optimal detection strategies.
A 78‐year‐old man was implanted with a cardiac resynchronization therapy defibrillator. One month later, chest X‐ray and electrocardiography suggested left ventricular (LV) lead dislodgement. However, the LV lead pacing threshold obtained by a programmer was unchanged because anodal capture had developed, which made it difficult to confirm the LV lead dislodgement. Radiographs obtained in the catheterization laboratory revealed that the tip of the LV lead had dislodged into the right atrium. The LV lead was relocated into another lateral coronary vein. Electrocardiography showed the QRS duration to be shorter than prior to this revision.
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Kashiwase et al. (2011) conducted a case report in Left ventricular lead dislodgement (n=1). Left ventricular lead relocation was evaluated on QRS duration. Anodal capture can mask left ventricular lead dislodgement by maintaining an unchanged pacing threshold, delaying diagnosis until radiographic confirmation and lead relocation.
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